Unsteady Gait

What is Unsteady gait?

An unsteady gait is a condition involving a problem with walking in a coordinated manner. Abnormalities in walking are very uncontrollable and unusual patterns of walking are normally caused by injuries, diseases to the feet, brain, legs, spine, as well as inner ear.

The manner in which an individual walks is referred to as their gait. There are many different kinds of abnormalities with walking which are formed automatically. There are some abnormalities with walking which are so distinctive they have been given explanatory names, for instance:

Propulsive gait

This is a stooped and rigid posture where the neck and head are turned forward.

Spastic gait

This is a stiff and foot-dragging walk caused by long-term, one-sided muscle contraction.

Scissors gait

The legs are slightly flexed at the knees and hips, giving the appearance of crouching with the knees and thighs crossing or hitting in a scissor-like motion.

Waddling gait

This is a distinctive duck-like walk which may appear in childhood or later in life.

Steppage gait

This is when the foot drops and hangs with the toes pointed downward, making the toes scrape along the ground when walking.

Unsteady Gait Causes

Gaits which are abnormal can happen because of diseases in various parts of the body. The broad causes of gaits which are abnormal can consist of:

• Conversion disorder
• Arthritis of foot joints or the leg
• Fracture
• Problems for the foot – such as callus, corn, ingrown toenail, wart etc
• Hemophilia
• Infection
• Injections in muscles which causes soreness in leg or buttocks
• Legs of different lengths
• Injury
• Myositis
• Torsion of the testis
• Shin splints
• Tendonitis
• Uncomfortable or tight shoes

This list of course is not all-embracing.

Causes of Definite Gaits

Propulsive gait

• Poisoning of carbon-monoxide
• Manganese poisoning
• Parkinson’s disease
• Certain drugs including haloperidol, phenothiazines, loxapine, thiothixene, metyrosine as well as metoclopramide

Scissors and spastic gait

• Cerebral palsy
• Cerebrovascular accident – stroke
• Cervical spondylosis with myelopathy
• Liver failure
• Multiple sclerosis
• Spinal cord trauma
• Pernicious anemia
• Spinal cord tumor
• Syphilitic meningomyelitis
• Cerebral palsy
• Syringomyelia

Steppage gait

• Herniated lumbar disk
• Guillain-Barre syndrome
• Multiple sclerosis
• Peroneal nerve trauma
• Poliomyelitis
• Peroneal muscle atrophy
• Spinal cord trauma
• Polyneuropathy

Waddling gait

• Congenital hip dysplasia
• Muscular dystrophy
• Spinal muscle atrophy

Broad-based or ataxic gait

• Alcohol intoxication
• Neuropathy – as with diabetes
• Long term brain injury due to alcoholism
• Use of certain drugs such as Dilantin
• Stroke

Unsteady Gait Treatment

First there needs to be a thorough evaluation by the primary care physician and perhaps then a referral to a specialist. A total history and physical will be needed as well as diagnostic and laboratory studies. The treatment will of course depend on the diagnosis after these tests.

Treatment usually corrects the gait. For instance, abnormalities of the gait caused by any injury to a section of the leg will get better as the leg starts to heal.

For propulsive gait

• The individual needs to be encouraged to get to a point where they are as independent and self-reliant as possible.
• Lots of time should be allowed for every day activities, specially walking. Individuals with this difficulty are vulnerable to falling because of balance that is poor and an effort which is unaware to try to catch up.
• Walking assistance should be provided for safety motives, particularly when the ground is uneven.
• A physical therapist should be consulted for exercise therapy as well as retraining on walking.

For scissors gait

• Failure of skin feeling is usually linked with this gait, so care of the skin should be available so as to evade skin ulcers or breakdown.
• Leg braces as well as splints in-shoe may help keep correct foot placement for walking and standing. A physical therapist may supply these as well as exercise therapy.

For spastic gait

• Both passive and active exercises are positive.
• Leg braces as well as splints in-shoe may help keep correct foot placement for walking as well as standing. A physical therapist may help with this as well as provide therapy exercise.
• A walker or cane is advised for anyone with poor balance

For steppage gait

• Sufficient rest is positive. Weariness often causes an affected individual to stumble and fall after stubbing the toe.
• Leg braces as well as splints in-shoe may help with maintaining foot placement for walking and standing as well as help from a physical therapist.